Provider Demographics
NPI:1467109728
Name:GARCIA, GINA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:GINA
Other - Middle Name:
Other - Last Name:DELA CRUZ DAGDAG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:13555 SE 36TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98006-1456
Mailing Address - Country:US
Mailing Address - Phone:866-839-6979
Mailing Address - Fax:
Practice Address - Street 1:13555 SE 36TH ST STE 100
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98006-1456
Practice Address - Country:US
Practice Address - Phone:866-839-6979
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-07
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60288229225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist